血清涎液化糖链抗原-6、分泌性磷蛋白1与肺炎支原体肺炎患儿病情程度相关性及联合预测预后的价值  

Correlation between serum KL-6,SPP1 levels with disease severity in MPP children and value of combination in predicting prognosis

作　　者：王丽丽[1] 王佳[1] 郝晓静 WANG Lili;WANG Jia;HAO Xiaojing(Department of Pediatrics,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院儿科,河北石家庄050051

出　　处：《陕西医学杂志》2025年第3期333-337,共5页Shaanxi Medical Journal

基　　金：河北省医学科学研究课题(20190370)。

摘　　要：目的:探究血清涎液化糖链抗原-6(KL-6)、分泌性磷蛋白1(SPP1)与肺炎支原体肺炎(MPP)患儿病情程度的相关性及联合预测预后的价值。方法:选取MPP患儿190例,根据病情程度分为轻症组(99例)和重症组(91例)。另选体检健康儿童95例为对照组。比较三组一般资料及血清KL-6、SPP1水平,分析MPP患儿入院时血清KL-6、SPP1水平及病情程度间的相关性。根据MPP患儿28 d预后情况分为预后良好组(129例)和预后不良组(61例),比较两组临床资料及生化指标,分析MPP患儿预后的影响因素及血清KL-6、SPP1对MPP患儿预后不良的预测价值。结果:重症组入院时血清KL-6、SPP1水平高于轻症组和对照组,且轻症组高于对照组(均P<0.05)。MPP患儿入院时血清KL-6、SPP1水平与病情程度呈正相关,且血清KL-6与SPP1呈正相关(均P<0.05)。患病至治疗时间、入院时病情程度、肺炎严重指数(PSI)评分及血清KL-6、SPP1水平为MPP患儿预后的危险因素,第1秒用力呼气肺活量(FEV1)/用力肺活量(FVC)是保护因素(均P<0.05)。入院时血清KL-6、SPP1单独预测MPP患儿预后不良的曲线下面积(AUC)分别为0.717、0.708;常规预测模型(患病至治疗时间、入院时病情程度、FEV1/FVC、PSI评分联合)预测MPP患儿预后不良的AUC为0.845,新预测模型(常规预测模型联合入院时血清KL-6、SPP1)预测MPP患儿预后不良的AUC为0.912,新预测模型的AUC明显大于常规预测模型的AUC(P<0.05)。结论:入院时血清KL-6、SPP1水平与MPP患儿病情程度呈正相关,且在预测患儿预后不良方面具有一定价值,与预后不良的常规影响因素联合能为临床预测预后不良高危患儿提供可靠临床依据。Objective:To explore the correlation between serum krebsvon den lungen-6(KL-6),secretory phosphoprotein 1(SPP1)with disease severity in mycoplasmal pneumonia pneumonia(MPP)children and the value of combination in predicting prognosis.Methods:A total of 190 children with MPP were enrolled.According to the severity of the disease,they were divided into mild group with 99 children and severe group with 91 children.Another 95 healthy children were selected as the control group.The general data and serum KL-6 and SPP1 levels of the three groups were compared,and the correlation between the serum KL-6,SPP1 levels and the degree of disease on admission in children with MPP was analyzed.According to the 28-day prognosis of children with MPP,they were divided into good prognosis group(129 cases)and poor prognosis group(61 cases),and the clinical data and biochemical indicators of the two groups were compared,and the influencing factors of the prognosis of children with MPP and the predictive value of serum KL-6 and SPP1 for poor prognosis of children with MPP were analyzed.Results:The severe group had significantly higher serum levels of KL-6 and SPP1 than the mild group and the control group at admission,and the mild group had significantly higher serum levels of KL-6 and SPP1 than the control group(all P<0.05).In children with MPP,the serum levels of KL-6 and SPP1 at admission were positively correlated with the severity of the disease,and the serum levels of KL-6 and SPP1 were positively correlated(all P<0.05).The time from illness to treatment,disease severity at admission,PSI score,and the levels of serum KL-6 and SPP1 were risk factors for the prognosis of children with MPP,while FEV1/FVC was protective factor(all P<0.05).The AUC of serum KL-6 and SPP1 on admission alone to predict poor prognosis in children with MPP was 0.717 and 0.708,respectively.The AUC of the conventional prediction model(the combination of time from illness to treatment,disease severity at admission,FEV1/FVC,and PSI score)in predicting the poo

关 键 词：肺炎支原体肺炎 涎液化糖链抗原-6 分泌性磷蛋白1 病情程度 预后 预测 

分 类 号：R725.6[医药卫生—儿科]